Are Injectable Fertility Drugs Safe?

I have all too often heard it said that medical providers knowingly
place unsuspecting infertile women at risk of developing cancer
through the fertility injectable drugs and treatment they administer
and that we knowingly place patients at risk by understating medical
risks associated with the use of fertility treatments
[/blog/ivf-pregnancies-bear-greater-risk/]. To me this is both
offensive and untrue. It is true that the indiscrim…

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Cervical Incompetence: A Common Cause of Late Miscarriage, Premature Birth and 2nd Trimester Recurrent Pregnancy Loss (RPL)

With cervical Incompetence (CI) the cervix starts to shorten (efface)
and dilate too early in the pregnancy giving rise to late (2nd
trimester) miscarriage or premature birth. It can occur with first
pregnancies (“Primary Cervical Incompetence”) or after a prior
pregnancy (“Secondary Cervical Incompetence”). CI often occurs in
women who give a history of cervical insufficiency in one or more
prior pregnancies; late miscarriages or premature deliveries of
unknown cause; cervical i…

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The Pro’s and Con’s of Preimplantation Genetic Testing (PGT) : It Should be Used Selectively

About a decade ago, I, along with my associate, Levent Keskintepe PhD
were the first to introduce full chromosome Preimplantation Genetic
Testing (PGT)
[/blog/preimplantation-genetic-sampling-pgs-using-next-generation-gene-sequencing-ngs-method-of-choice/]
into the IVF clinical realm to try and identify euploid embryos whose
cells contained the required 46 chromosomes…

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Case Report: Treating Hydrosalpinx by Surgical Removal (Salpingectomy) as a Prelude to IVF

CASE REPORT: **For the purposes of anonymity, I will be referring to
the patient as RL throughout this blog.** RL, a 31-year-old woman,
presented with a 7 year history of inability to conceive, in spite of
2 prior fresh and 1 frozen IVF attempts
[/blog/frozen-embryo-transfer-fet-versus-fresh-et-make-decision/],
where a total of six

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CASE REPORT: A woman in her Early 40’s who has Diminished Ovarian Reserve Requiring IVF with Embryo Banking and PGS.

Hi Dr Sher, I’m 42 years of age. Until very recently, I knew nothing
about IVF, and I now find myself in a scramble to optimize my chances
with it. Despite a lifelong dream of having a healthy baby and happy
family, it has taken me this long to find a great man/dad I can
believe in for my unborn kids, so prior, I always used protection and
never tried to get pregnant. Since my mom got pregnant naturally at
40, I grew up thinking that was normal-or at least normal for my
family. And, I …

CASE REPORT: A woman in her Early 40’s who has Diminished Ovarian Reserve Requiring IVF with Embryo Banking and PGS. Read More »

Defining and Addressing an Abnormal Luteal Phase

Following ovulation, what remains of the ruptured follicle transforms
itself into a structure called the Corpus Luteum (CL) which produces
progesterone. The purpose of progesterone is to prepare the uterus to
accept and support an early pregnancy until it is able to sustain
itself at around 8-10 weeks of gestation.
The life span of the CL is predetermined to be 12-13 days, unless
rescued by a signal from the early pregnancy. If no pregnancy occurs,
the CL …

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IVF Should Supplant Tubal Fertility Surgery

A progressive increase in success rates with IVF
[/blog/ivf-personalized-step-step-approach/] versus tubal fertility
surgery [/blog/role-ivf-cases-tubal-damage/] has over the last 25
years brought about a shift away from the latter to the former. And so
it should be, because even in young women, attempted surgical
restoration of compromised Fallopian tubes
[/blog/role-ivf-cases-tubal-damage/] is by and large associated w…

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Endometriosis and Immunologic Implantation Dysfunction (IID) and IVF

More than half of women who have endometriosis harbor antiphospholipid
antibodies (APA) that can compromise development of the embryo’s root
system (trophoblast). In addition and far more serious, is the fact
that in about one third of cases endometriosis
[/blog/endometriosis-and-ivf/], regardless of its severity is
associated with NKa and cytotoxic uterine lymphocytes (CTL) which can
seriously jeopardize implantat…

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IVF: A Personalized Step-by Step Approach

The ability to grow a healthy plant requires that a “good” seed be
planted in a “fertile soil” and then be properly nurtured until
it can thrive on its own….independent of intervention.
Similarly, successful IVF requires the same relationship, only here,
a “good seed” is a “competent, chromosomally normal (euploid)
embryo and “fertile soil” is a “receptive” uterine
lining (endometrium). You cannot expect success through planting a
“bad seed” in a “fert…

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